The chronic treatment of gout affecting the big toe or other toes requires daily or prophylactic treatment with one or more drugs. These drugs, such as colchicine, allopurinol, probenecid or indomethacin or combinations of these, have numerous side effects that can cause with time considerable toxicity. In addition, they may adversely affect the action of other drugs given to the patient to treat completely different conditions. More importantly, when the drugs are used to affect small areas such as the toes, relatively high doses must be given which produce overall much greater effects on other body tissues than the toes due to the general distribution of the drug when given by the oral route.
It would appear more logical, when the object of therapy is to produce a local anti-inflammatory effect, to treat each local site of inflammation with lower doses of the anti-inflammatory drugs than would be given orally. The local concentrations under these conditions, at the joint, would still be considerably higher than giving such anti-inflammatory drugs orally, where the drug is distributed to all the body tissues and thus diluted. This local application should be domethacin and phenylbutazone (non-steroidal anti-inflammatory agents) as well as colchicine, which works by a different mechanism.
It is an object of the present invention, therefore, to provide anti-inflammatory treatment of joints by topical application so as to avoid the need for high concentrations of anti-inflammatory drugs normally taken orally and to enable a therapeutic effect to be provided to the joint by more direct and therefore less toxic application.